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Plants being sessile are exposed to different environmental challenges and consequent stresses associated with them. With the prerequisite of minerals for growth and development, they coordinate their mobilization from the soil through their roots. Phosphorus (P) and iron (Fe) are macro- and micronutrient; P serves as an important component of biological macromolecules, besides driving major cellular processes, including photosynthesis and respiration, and Fe performs the function as a cofactor for enzymes of vital metabolic pathways. These minerals help in maintaining plant vigor via alterations in the pH, nutrient content, release of exudates at the root surface, changing dynamics of root microbial population, and modulation of the activity of redox enzymes. Despite this, their low solubility and relative immobilization in soil make them inaccessible for utilization by plants. Moreover, plants have evolved distinct mechanisms to cope with these stresses and coregulate the levels of minerals (Fe, P, etc.) toward the maintenance of homeostasis. The present study aims at examining the uptake mechanisms of Fe and P, and their translocation, storage, and role in executing different cellular processes in plants. It also summarizes the toxicological aspects of these minerals in terms of their effects on germination, nutrient uptake, plant–water relationship, and overall yield. Considered as an important and indispensable component of sustainable agriculture, a separate section covers the current knowledge on the cross-talk between Fe and P and integrates complete and balanced information of their effect on plant hormone levels.

Introduction: Blood donor deferral is vital for ensuring safe blood transfusion. However, with the unfolding Coronavirus Disease-2019 (COVID-19) pandemic, significant changes were made in donor screening and blood donation criteria, resulting in a shift in the pattern of donor deferrals. Aim: To estimate the blood donor deferral patterns during the COVID-19 pandemic. Materials and Methods: A retrospective cross-sectional study was conducted in the Department of Transfusion Medicine at SMHS Hospital/GMC Srinagar, Jammu and Kashmir, India. The study spanned two years, from March 2020 to February 2022. All blood donors were screened in accordance with the Ministry of Health and Family Welfare (MOHFW), National Acquired Immune Deficiency Syndrome (AIDS) control organisation (National blood transfusion services) 2017 guidelines. The data was analysed in Microsoft Excel, considering factors such as age, gender, type of deferral, and reasons for deferral. Results: Deferred blood donors were most common in the age group of 18-33 years. During the study period, a total of 19,895 blood donors (19493 males and 402 females) were registered for blood donation. Out of these, 3441 donors (17.30%) were deferred, with a male donor deferral rate of 3258/19493 (16.71%) and a female donor deferral rate of 183/402 (45.52%). Temporary blood donor deferrals accounted for 3272 (95.09%) cases, while permanent deferrals were 169 (4.91%). The most common cause of deferral was low haemoglobin, accounting for 991/3441 (28.80%) cases, followed by deferrals due to reasons attributable to the COVID-19 pandemic (786/3441, 22.84%) and hypertension (653/3441, 18.98%). Conclusion: The study observed a substantial increase in the total donor deferral rate, as well as a change in the donor deferral pattern during the COVID-19 pandemic.

Cytokine storm (CS) refers to the spontaneous dysregulated and hyper-activated inflammatory reaction occurring in various clinical conditions, ranging from microbial infection to end-stage organ failure. Recently the novel coronavirus involved in COVID-19 (Coronavirus disease-19) caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) has been associated with the pathological phenomenon of CS in critically ill patients. Furthermore, critically ill patients suffering from CS are likely to have a grave prognosis and a higher case fatality rate. Pathologically CS is manifested as hyper-immune activation and is clinically manifested as multiple organ failure. An in-depth understanding of the etiology of CS will enable the discovery of not just disease risk factors of CS but also therapeutic approaches to modulate the immune response and improve outcomes in patients with respiratory diseases having CS in the pathogenic pathway. Owing to the grave consequences of CS in various diseases, this phenomenon has attracted the attention of researchers and clinicians throughout the globe. So in the present manuscript, we have attempted to discuss CS and its ramifications in COVID-19 and other respiratory diseases, as well as prospective treatment approaches and biomarkers of the cytokine storm. Furthermore, we have attempted to provide in-depth insight into CS from both a prophylactic and therapeutic point of view. In addition, we have included recent findings of CS in respiratory diseases reported from different parts of the world, which are based on expert opinion, clinical case-control research, experimental research, and a case-controlled cohort approach.

Plants that possess a diverse range of bioactive compounds are essential for maintaining human health and survival. The diversity of bioactive compounds with distinct therapeutic potential contributes to their role in health systems, in addition to their function as a source of nutrients. Studies on the genetic makeup and composition of bioactive compounds have revealed them to be rich in steroidal alkaloids, saponins, terpenes, flavonoids, and phenolics. The Solanaceae family, having a rich abundance of bioactive compounds with varying degrees of pharmacological activities, holds significant promise in the management of different diseases. Investigation into Solanum species has revealed them to exhibit a wide range of pharmacological properties, including antioxidant, hepatoprotective, cardioprotective, nephroprotective, anti-inflammatory, and anti-ulcerogenic effects. Phytochemical analysis of isolated compounds such as diosgenin, solamargine, solanine, apigenin, and lupeol has shown them to be cytotoxic in different cancer cell lines, including liver cancer (HepG2, Hep3B, SMMC-772), lung cancer (A549, H441, H520), human breast cancer (HBL-100), and prostate cancer (PC3). Since analysis of their phytochemical constituents has shown them to have a notable effect on several signaling pathways, a great deal of attention has been paid to identifying the biological targets and cellular mechanisms involved therein. Considering the promising aspects of bioactive constituents of different Solanum members, the main emphasis was on finding and reporting notable cultivars, their phytochemical contents, and their pharmacological properties. This review offers mechanistic insights into the bioactive ingredients intended to treat different ailments with the least harmful effects for potential applications in the advancement of medical research.

As of 25th July, 2022, global Disease burden of 575,430,244 confirmed cases and over 6,403,511 deaths have been attributed to coronavirus disease 2019 (COVID-19). Co-infections/secondary infections continue to plague patients around the world as result of the co-morbidities like diabetes mellitus, biochemical changes caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) especially significant elevation in free iron levels, immune suppression caused by SARS-CoV-2, and indiscriminate use of systemic corticosteroids for the treatment of severe COVID-19 disease. In such circumstances, opportunistic fungal infections pose significant challenge for COVID-19 disease therapy in patients with other co-morbidities. Although COVID-19-associated Mucormycosis (CAM) has been widely recognized, currently extensive research is being conducted on mucormycosis. It has been widely agreed that patients undergoing corticosteroid therapy are highly susceptible for CAM, henceforth high index of screening and intensive care and management is need of an hour in order to have favorable outcomes in these patients. Diagnosis in such cases is often delayed and eventually the disease progresses quickly which poses added burden to clinician and increases patient load in critical care units of hospitals. A vast perusal of literature indicated that patients with diabetes mellitus and those with other co-morbidities might be highly vulnerable to develop mucormycosis. In the present work, the case series of three patients presented at Chest Disease Hospital Srinagar, Jammu and Kashmir infected with CAM has been described with their epidemiological data in supplementary section. All these cases were found to be affected with co-morbidity of Diabetes Mellitus (DM) and were under corticosteroid therapy. Furthermore, given the significant death rate linked with mucormycosis and the growing understanding of the diseases significance, systematic review of the literature on CAM has been discussed and we have attempted to discuss emerging CAM and related aspects of the disease.

Background: Due to an enormous health care crisis arising out of COVID-19 pandemic, alternate methods of seeking treatment like tele-consultation proved useful to patients. We assessed the role of teleconsultation in managing COPD exacerbations at home in the times of COVID-19 crisis. Materials and Methods: A prospective study of 527 diagnosed cases of COPD seeking treatment for exacerbation of their illness telephonically because of difficulty in visiting the hospitals created by the COVID-19 lockdown. Data were collected telephonically and via social media platforms from April 7,2020 to October 29, 2020. The patients were treated for exacerbation and followed telephonically at day 3,5,7, 14 and day 30. Patients who turned to be COVID-19 positive were referred to COVID health facility centers. Results: 509 patients out of 527 patients were treated for exacerbation of COPD, 18 patients tested positive for COVID-19. Out of 509, 13 patients did not improve and had to be referred to hospital. All of them had acute respiratory failure (Type 2) as documented by their arterial blood gas analysis. 2 out of them did not survive. 496 out of 509 (97.4%) patients of COPD exacerbation were successfully treated via teleconsultations and with a follow-up of 4 weeks period minimum for all the patients. Conclusion: Teleconsultation provided excellent means to manage COPD exacerbation remotely with equally effective outcome as seen in hospital care in the times of health care crises due to COVID-19 pandemic.

Aim: To study the impact of age, gender and comorbidities/risk factors affecting the severity of CoronaVirus Disease 2019/Severe acute respiratory syndrome coronavirus 2 (COVID-19/SARS-COV-2) infection in the Kashmiri community. Materials and Methods: The present descriptive cross-sectional study was conducted in the Chest Disease Hospital. The study included 957 subjects who were diagnosed with SARS-CoV-2 infection. Descriptive statistics were calculated. Results: In the age group 60 years, the severity of illness was found to be 35.74% and the occurrence of death was 10.49%. In males, the severity of the illness was found to be 32.39% and the occurrence of death was 11.27%. In females, the severity of the illness was found to be 33.96% and the occurrence of death was 12.58%. In patients suffering from chronic obstructive pulmonary disease (COPD), asthma, diabetes mellitus, coronary artery disease (CAD), chronic kidney disease (CKD), cancer, hypertension, chronic liver disease (CLD), cerebrovascular disease, thyroid disease, steroid use, obstructive sleep apnoea (OSA) and smokers, the severity of the illness was 29.27, 41.67, 37.73, 20, 23.53, 11.11, 36.30, 40, 20, 36.37, 50, 54.54 and 36% and the occurrence of death was 14.63, 0, 10.69, 10, 11.76, 5.55, 10.67, 0, 0, 20.78, 0, 0 and 16%, respectively. Conclusion: The age, gender and comorbidity disparities seen in the COVID-19 vulnerability emphasise the need to understand the impact of these factors on the incidence and case fatality of the disease.

Introduction: Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection risks in co-morbid patients are still unknown two years after the pandemic began. The prevalence of antibodies against SARS-CoV-2 infection is crucial for determining disease preventive and mitigation strategies. Obesity, type 2 diabetes, and chronic cardiovascular disease can raise the risk of Coronavirus Disease-2019 (COVID-19), which has a greater morbidity and fatality rate. Aim: To determine the seroprevalence of SARS-CoV-2 (COVID-19) antibodies and their relationship to co-morbidities in Kashmir’s ethnic population. Material and Methods: The present observational cohort study was done in the Department of Pulmonary Medicine at Chest Disease Hospital Srinagar, Jammu and Kashmir, India, from September 2020 to September 2021 and 1,846 co-morbid unvaccinated patients were chosen for the study. As per standard methodology, a cohort study was undertaken, a questionnaire was prepared, and demographic and associated parameters were recorded. All participants had their immune profiles tested, and the existence of Immunoglobulin G (IgG) antibodies for SARS-CoV-2 was determined using the chemiluminisence immunoassay technique. Chi-square and Fischer exact test were used for stastical analyses and p-value

The treatment and outcome of respiratory virus infections differ. SARS-CoV-2, as well as other respiratory viruses such as influenza virus (A and B) and respiratory syncytial virus (RSV), require simultaneous, cost-effective, and rapid differential detection. We used a gold standard five-target single-step RT-PCR to detect influenza viruses, RSV, and SARS-CoV-2, and this method can be extended to detect influenza virus subtypes. As a result, this five-target single-step RT-PCR method is ideal for differentiating respiratory viruses. The 5’ nuclease activity of Taq DNA polymerase is used in the real-time reverse transcription PCR assay. The Taq man fast viral 1-step enzyme is a 4× Master mix and five-target primer probe mix that detects influenza A, influenza B, SARS-CoV-2 ORF1ab, respiratory syncytial viruses A/B and actin. When compared with TaqMan TM and Invitrogen superscript TM III Platinum and the Meril Kit for SARS-CoV-2, the assay demonstrated 100% sensitivity, specificity, and amplification efficiency of 90.1% for target genes. In conclusion, our one-tube multiplex RT-PCR assay offers a rapid and reliable method for the simultaneous detection of influenza A/B, RSV, and SARS-CoV-2 from nasopharyngeal swabs. This assay has the potential to enhance diagnostic capabilities and improve public health responses during respiratory outbreaks, enabling timely interventions and informed decision making.

Herpes zoster (HZ) duplex symmetricus is an extremely rare variant of multidermatomal HZ where there is the involvement of bilaterally symmetrical dermatomes. This generally occurs in immuno-compromised individuals and is unusual in immunocompetent host. When occurring over the face, it can be associated with Ramsay Hunt syndrome. Bilateral symmetrical lesions present a unique diagnostic dilemma owing to morphological similarities with Eczema Herpeticum and rarely enteroviral infections. In such cases, correct interpretation of serological tests helps in the diagnosis of the condition. Here, we present the case of HZ duplex symmetricus occurring in an immune-competent individual over bilateral V1 3 and C4 dermatome (left) along with facial palsy.

The present study evaluated the clinical presentation and outcome of COVID-19 patients with underlying hypercreatinemia at the time of hospitalization. A retrospective observational study was conducted from the 23rd of March 2020 to the 15th of April 2021 in 1668 patients confirmed positive for COVID-19 in the Chest Disease Hospital in Srinagar, India. The results of the present study revealed that out of 1668 patients, 339 with hypercreatinemia had significantly higher rates of admission to the intensive care unit (ICU), severe manifestations of the disease, need for mechanical ventilation, and all-cause mortality. Multivariable analysis revealed that age, elevated creatinine concentrations, IL-1, D-Dimer, and Hs-Crp were independent risk factors for in-hospital mortality. After adjusted analysis, the association of creatinine levels remained strongly predictive of all-cause, in-hospital mortality (HR-5.34; CI-4.89–8.17; p ≤ 0.001). The amelioration of kidney function may be an effective method for achieving creatinemic targets and, henceforth, might be beneficial for improving outcomes in patients with COVID-19.

Abstract Background The data on medium-term follow-up of coronavirus disease-19 (COVID-19) pneumonia survivors is scarce. Medium-term follow-up will generate knowledge and help in devising a structured follow-up plan and to facilitate enrolment in clinical trials assessing the role of antifibrotic drugs in modifying the course of disease in order to avert long-term pulmonary sequelae of disease. The study was aimed to evaluate the lung findings on a medium-term follow-up (3 months or more) chest computed tomography (CT) in COVID-19 pneumonia survivors, assess the rate of resolution or persistence of lung abnormalities and to identify the initial demographic, clinical, and imaging characteristics that could potentially predict the persistence of lung abnormalities on follow-up. Results Out of the total study cohort of 81 patients, 46 (56.8%) demonstrated complete resolution of lung findings and the remaining 35 (43.2%) had residual lung opacities on follow-up CT. The most common type of residual abnormality was ground glass opacity (GGO) (16/35; 45.7%), followed by parenchymal bands (9/35; 25.7%), mixed pattern of GGO and parenchymal bands (6/35; 17.2%), bronchiectasis (6/35; 17.2%), and interlobular septal thickening (4/35; 11.4%). Patients with residual abnormalities were older, had higher BMI, more comorbidities, lower SpO2, longer hospital stay, higher rate of intensive care unit (ICU) admission, higher WBC count, a higher CT severity score, and lower rate of steroid administration with all p values < 0.05. Conclusion Nearly half of post-COVID-19 survivors had residual lung abnormalities after ≥ 3 months of follow-up. Certain clinico-radiological characteristics have the potential to identify the individuals at risk of having residual lung abnormalities on medium-term follow-up.

Immune hemolytic disease of the fetus and newborn is a condition in which there is the premature destruction of fetal or neonatal red cells due to maternal alloantibody against red cell antigen inherited from father. We report the case of Hemolytic disease of fetus and newborn (HDFN) due to anti-E and anti-Fya antibody. Blood grouping was done using the conventional tube technique. Rh and Kell phenotyping of the patient and her husband performed by column agglutination and Duffy phenotyping were done by the conventional tube technique. Direct antiglobulin test was performed by column agglutination technique. Antibody screening and identification were done. Anti-E and Anti-Fya were identified with titer of Anti-E: 1:64 and Anti-Fya: 1:256. The patient's neonate developed jaundice. Phototherapy was given. Bilirubin stabilized and discharged on the 12th day.

Background and Objectives: Crossmatching is one of the bases of pretransfusion testing. Resolving problems in crossmatching should be carried out after proper planning and following departmental guidelines, and hence that time is not wasted, or blood withheld from patient unnecessarily. The aim of this study was to find the prevalence and cause of incompatible crossmatch and to formulate root cause analysis to help ensure safe transfusion. Materials and Methods: This was a prospective study conducted at a tertiary care hospital in North India, from December 2018 to November 2019. Request for blood components was received along with 2 ml labeled sample in ethylenediaminetetraacetic acid and plain tube. Crossmatching was done by column agglutination method in polyspecific (IgG + C3d) bead cards by ortho clinical diagnostic using semi-automated biovue. In case of any incompatible result, it was resolved using appropriate steps. Results: During the study period from December 2018 to November 2019, only 67 (0.65%) of the 10,320 samples received were found to be crossmatch incompatible and evaluated and appropriate donor units issued. The crossmatch incompatibility was much higher in the females (46, 68.7%) than the males (21, 31.3%). The direct antiglobulin test (DAT) was positive in nine patient samples, and the indirect antiglobulin test was found positive in 37 incompatible crossmatch units. Eleven cases of incompatible crossmatch were due to wrong blood in tube, seven due to contamination of reagents, and three due to DAT-positive donor units. Conclusion: In this study, alloimmunization (55.2%) was the most prevalent cause of incompatible crossmatch, and the most common alloantibody identified was anti-E. Incompatible crossmatch poses a challenge in the field of transfusion medicine. Root cause analysis is a systemic method for identifying all the contributing factors to a problem, so that the corrective action can be taken. A logical stepwise approach will enable the provision of safe transfusion.

Introduction: Tuberculosis (TB) is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. TB is one of the biggest public health challenges in the world especially in under-developing and developing countries. Aim: To determine the prevalence of TB in the Kashmir valley. Materials and Methods: The present cross-sectional study was conducted in the Department of Chest Medicine, Chest Diseases Hospital (CDH), Government Medical College, Srinagar and Intermediate Reference Laboratory (IRL), State TB Training and Demonstration Centre (STDC), CDH, Srinagar and in association with State TB Office (STO) Kashmir, India, from March 2019 to December 2020 in 10 districts. A total of 66,829 presumptive TB samples in 2019 inclusive of 450 samples of CDH and 63532 presumptive TB samples in 2020 inclusive of 400 samples of CDH were collected from Department of Chest Medicine, CDH, Government Medical College, Srinagar and Revised National TB Control Programme (RNTCP) Centres of Kashmir valley under State TB office Director Health Kashmir as per World Health Organisation (WHO) criteria. It included both the positive and negative cases of TB registered during the year 2019 and 2020. Results: The total prevalence of TB disease during the year 2019 was found to be 49.03 per 100,000 population and 37.31 per 100,000 population in the year 2020 respectively. There was no correlation among the surveyed demographics in the positive TB cases in the Kashmir valley (p>0.05). Srinagar city reported highest cases whereas Budgam and Pulwama reported least cases in the year 2019 and 2020. Conclusion: The respiratory precautionary measures like social distancing and use of face masks during the ongoing COVID-19 pandemic has reduced transmission and incidence of TB. Proper identification and treatment of infectious cases will prevent TB in the ethnic population. More studies are needed on large sample size.